Cutting electrode enhancement for laparoscopic electrosurgical device

ABSTRACT

An electrosurgical electrode for coagulating and cutting tissue includes a main body fabricated from a conductive material, and a conductive blade extending inwardly from an inner surface of the main body. The blade has an edge configured to concentrate RF for cutting tissue.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of the filing date of provisionalU.S. Patent Application No. 62/722,679 filed, Aug. 24, 2018.

FIELD

The present disclosure relates to laparoscopic electrosurgicalinstruments and, more particularly, to an electrosurgical electrode fortreating and/or dissecting tissue.

BACKGROUND

Current laparoscopic electrosurgical (e.g., RF) electrodes areconfigured to provide optimal coagulation performance and mechanicaltissue dissection at the expense of the devices ability to transecttissue using electrosurgical “CUT” waveforms. This is intentional asmany surgeons need much more coagulation capabilities, but duringprocedures, it can be observed that the surgeon will tug on tissue inorder to transect the tissue plane. When the tissue divides the activeelectrode then moves out of the field of view so the surgeon then needsto get the electrode end back in to the view of the camera.

SUMMARY

The present disclosure provides a feature for laparoscopic electrodesthat includes a surface in a location where RF concentration can be usedto improve the tissue transection ability of the device at much reducedpower using the CUT or modified CUT waveform while not negativelyimpacting the coagulation abilities of the device. This will allowsurgeons to use less errant motion during dissection, have clean tissueplane transection through a variety of tissue impedances, and minimizethermal spread and tissue charring but not change the typicalcoagulation usage. Using RF concentration in a place of the electrodethat is not typically used for coagulation, the laparoscopic electrodethen will effectively do both cutting and coagulation.

In accordance with an aspect of the present disclosure, anelectrosurgical electrode is provided for coagulating and cuttingtissue. The electrosurgical electrode includes a main body fabricatedfrom a conductive material, and a blade. The main body includes a distalend portion, which has an inner surface, and a curved outer surfaceconfigured to coagulate tissue. The blade extends from the inner surfaceof the distal end portion and has an edge configured to concentrate RFfor cutting tissue.

In aspects, the blade may extend inwardly from the inner surface of thedistal end portion.

In aspects, the blade may have a pair of opposite side surfacesconverging toward the edge.

In aspects, the pair of opposite side surfaces may be coated with anon-conductive material.

In aspects, the edge may be devoid of the non-conductive material.

In aspects, the inner and outer surfaces of the distal end portion maybe coated with the non-conductive material.

In aspects, the coating of the non-conductive material on the pair ofopposite side surfaces may be thicker than the coating of thenon-conductive material on at least one of the inner or outer surfacesof the distal end portion.

In aspects, the blade and the main body may be coextruded.

In aspects, the main body may be flat and have a curved distalperipheral edge. The inner surface of the distal end portion may beconcave and the outer surface of the distal end portion may be convex.

In aspects, the main body may include a long leg and a short legextending perpendicularly from the long leg. The blade may extendinwardly from at least one of the long leg or the short leg.

In accordance with another aspect of the present disclosure, anelectrosurgical electrode for coagulating and cutting tissue is providedand includes a main body fabricated from a conductive material and aconductive blade. The main body includes a linear segment and a arcuatesegment extending from the linear segment, an inner surface, and anouter surface configured to coagulate tissue. The conductive bladeextends from the inner surface of the main body. The conductive bladehas a sharp edge configured to concentrate RF for cutting tissue.

In aspects, the conductive blade may project from the inner surface ofthe main body.

In aspects, the conductive blade may have a pair of opposite sidesurfaces converging toward the edge.

In aspects, the pair of opposite side surfaces may be coated with anon-conductive material.

In aspects, the edge may be devoid of the non-conductive material.

In aspects, the inner and outer surfaces of the main body may be coatedwith the non-conductive material.

In aspects, the coating of the non-conductive material on the pair ofopposite side surfaces may be thicker than the coating of thenon-conductive material on at least one of the inner or outer surfacesof the main body.

In aspects, the main body may be flat and have a curved distalperipheral edge. The inner surface of the main body may be concave andthe outer surface of the main body may be convex.

In aspects, the main body may include a short leg extendingperpendicularly from the linear segment. The arcuate segment mayinterconnect the linear segment and the short leg.

In aspects, the conductive blade may extend inwardly from at least oneof the linear segment, the arcuate segment, or the short leg.

BRIEF DESCRIPTION OF THE DRAWINGS

Various aspects and features of the present disclosure are describedhereinbelow with reference to the drawings wherein like numeralsdesignate identical or corresponding elements in each of the severalviews:

FIG. 1 is a partial perspective view illustrating an electrosurgicalelectrode in accordance with an embodiment of the present disclosure;

FIG. 2 is an enlarged view of a distal end portion of theelectrosurgical electrode of FIG. 1 ;

FIG. 3 is a partial perspective view illustrating an electrosurgicalelectrode in accordance with another embodiment of the presentdisclosure;

FIG. 4 is a partial perspective view illustrating an electrosurgicalelectrode in accordance with another embodiment of the presentdisclosure; and

FIG. 5 is a partial perspective view illustrating an electrosurgicalelectrode in accordance with another embodiment of the presentdisclosure.

DETAILED DESCRIPTION

In an embodiment of the present disclosure, an RF concentration featureis electrically connected to the electrode but located on a surface notused for coagulation. The RF concentration feature may be metal andformed by a metal extrusion technique (e.g., co-extruded with theelectrode) or any other suitable metal forming techniques such as, butnot limited to, metal injection forming or metal 3D printing. The entireelectrode may be coated with a non-stick coating to a particularthickness to maintain RF performance. However, along the sides of the RFconcentration feature, the non-stick coating and/or a more isolativecoating may be applied to provide a non-conductive surface. Features tothis surface may also enable increased adherence or cohesion of thenon-conductive coating such as surface treatment, convex features, orother designs to increase surface tension for the coating. A very smallradius will be left exposed. This will end up concentrating RF energy ona thin isolated edge (e.g., radius of about 0.40 mm or less).

RF concentration produces minimal thermal damage with superior cuttingability at very low power levels. The limit of concentrating the RF on athin edge is that the electrode no longer provides adequatehemostasis/coagulation power. These edges are located on surfaces thatare not useful for general purpose RF application where coagulation isneeded. During dissection procedures, the surgeon can often be seentugging the tissue to get it the tissue to separate. The presentdisclosure provides for adding an RF concentration feature where edgesare placed for enhancing the cutting ability of the laparoscopicelectrode while not inhibiting the coagulation abilities of theelectrode.

For example, in an embodiment of the present disclosure, an RFconcentration feature is included on the internal edge of the hook wheremost of the hooking action on the device occurs. This additional featurewould allow the surgeon to hook the tissue but, instead of tugging toachieve tissue separation, a small low power pulse of RF “CUT” ormodified “CUT” mode activation would easily cut the tissue at theexposed edge of the feature. By doing so, the electrode now stays withinthe limited site of view of the laparoscopic camera as tugging oftendisplaces the hook from the field of view. This also reduces trying touse a coagulation waveform to transect tissue which may causeunnecessary charring to the tissue and does not provide for as clean ofa tissue transection as “CUT” mode does. Additionally, the RFconcentration feature allows for the power level used for “CUT” mode tobe reduced since the exposed edge of the feature focuses the RF energyfor transecting.

An RF concentration feature can be added in a variety of locationswithout impacting the typical coagulation surfaces of the electrodes.For example, with a laparoscopic wire L-shaped hook electrode 10 (FIGS.1-4 ) or a laparoscopic spatula electrode 100 (FIG. 5 ), the featurecould be added to any suitable location (e.g., lower edge, upper edge,back edge, front edge, interior curvature, exterior curvature, etc.) onthe electrode, as will be described in further detail below.

The present disclosure provides for an electrosurgical electrode havingimproved tissue transection performance without altering other keysurfaces used for blunt dissection and hemostasis. Typically, the userdrags the surfaces at the tip of the L-hook, or the edge of the spatulafor blunt dissection. When the user desires hemostasis, the broader flatsurfaces of the electrode are RF activated and placed in contact withthe bleeding surface.

One dissection method uses the RF energy while tugging the tissue in thehook or across the broad curve surface of the spatula to transect thetissue. When doing this, the tissue doesn't always cleanly divide and/orunpredictable divides in the tissue may cause the electrode to touchadjacent tissue resulting in unintentional burns to the tissue surface.The surgeon may be unaware of the above-noted incident since theelectrode may be out of the line of site of the surgeon.

In addition to the small RF active edge internal to the L-hook electrodeor along the passive surface of the spatula electrode, additionalfunctionality may now be added to the specific surfaces used morecommonly for either dissection or hemostasis. The broad flat surfacesused for hemostasis can now have a thicker non-stick coating thatenables them to have less eschar buildup and to be electrically activeonly when using specific coagulation waveforms (surface etching patternsor perforations on the coating can further enable this). Currently thesesurfaces are always RF hot when any surface of the electrode is beingused. These surfaces are often not in the direct line of site of thesurgeon, so it can cause inadvertent burns to tissue if accidentallyresting up against tissue. The embodiments of the present disclosurewould make the activation of the broader surface an intentional action.This can also be applied to monopolar scissors where all surfaces of theboth blades are RF hot during activation. If the coatings werespecifically designed so that the convex surface and bottom edges of thescissors were RF inert or RF active only on special coagulation modes,then inadvertent application of energy to tissue adjacent to thescissors could be mitigated without cumbersome solutions (like a siliconboot).

The present disclosure also provides for surfaces used only for bluntdissection to be designed to either allow greater RF currentconcentration for faster blunt dissection, or coated in such a manner asto not allow any RF to pass through the coated portion of the electrode.To further enhance the performance of those surfaces used only for bluntdissection, coatings and shapes may be added to enable dissection orhemostasis to be enhanced. Also, RF activation can then be controlled byspecific surface design of the electrode.

With reference to FIGS. 1 and 2 , an exemplary embodiment of anelectrosurgical electrode 10 for coagulating and cutting tissue isillustrated. The electrode 10 includes a main body 12 and a conductiveblade 14 attached to the main body 12. The main body 12 has a proximalend portion 12 a configured to be coupled at its proximal end to ahandle assembly (not explicitly shown) of a hand-held electrosurgicalinstrument, such as, for example, the handle assembly shown an describedin U.S. Patent Application Publication No. 2011/0219887, filed on Jun.23, 2010, the entire contents of which being incorporated by referenceherein. The main body 12 is fabricated from a conductive material (e.g.,steel, aluminum, copper, etc.) and includes a distal end portion 12 bfor coagulating and cutting tissue. The main body 12 is in electricalcommunication with an energy source, such as, for example, an RF energysource (not shown) for delivering a selected amount of RF energy to themain body 12.

The distal end portion 12 b of the main body 12 has a long leg, such as,for example, a linear segment 16, a short leg 18, and a curved segment20 interconnecting the long and short legs 16, 18. It is contemplatedthat the distal end portion 12 b assumes an L-shaped configuration.However, other shapes and configurations for the distal end portion 12 bare contemplated. The distal end portion 12 b of the main body 12 has aninner surface 22, and an outer surface 24 disposed on an opposite sideof the main body 12. The outer surface 24 is configured to coagulatetissue upon contact.

The conductive blade 14 extends or projects inwardly (e.g., in adirection away from the outer surface 24) from the inner surface 22 ofthe distal end portion 12 b. The conductive blade 14 extendslongitudinally along a longitudinal axis defined by the long leg 16. Asshown in FIGS. 1 and 2 , the conductive blade 14 extends along a distalsection of the long leg 16, over the curved segment 20, and terminatesbefore the short leg 18. In aspects, the conductive blade 14 may extendalong any portion of the inner surface 22 of the main body 12. Forexample, with brief reference to FIG. 3 , the conductive blade 14 mayextend along an entire length of the long segment 16. As anotherexample, with brief reference to FIG. 4 , the conductive blade 14 mayonly extend along the length of the short leg 18.

With continued reference to FIGS. 1 and 2 , the blade 14 has a pair ofopposite side surfaces 14 a, 14 b converging in an edge 14 c configuredto concentrate RF for cutting tissue. In aspects, blade 14 may assume atriangular transverse cross-sectional configuration. The side surfaces14 a, 14 b are coated with a non-stick and non-conductive material 28,such as, for example, polytetrafluoroethene. The edge 14 c may besharpened to facilitate cutting of tissue. In aspects, the edge 14 c maybe rounded or otherwise blunt. In aspects, the edge 14 c may be devoidof the coating, such that the edge 14 c functions as an exposedconductive and sharpened surface for concentrating RF energy. Inaspects, the side surfaces 14 a, 14 b may have a thicker coating of thenon-stick and non-conductive material than the outer surface 24 of themain body 12 or have a more insulative coating than the outer surface24.

With reference to FIG. 5 , another embodiment of an electrosurgicalelectrode 100 is illustrated, similar to the electrosurgical electrode10. The electrosurgical electrode 100 includes a main body 112 and ablade 116 attached to the main body 112. The main body 112 is flat withan elongated oval configuration. The main body 112 has a curved distalend portion 115 defining a curved distal peripheral edge 118. The curveddistal end portion 115 of the main body 112 has a concave inner surface122 and a convex outer surface 124. The blade 116 projects inwardly fromthe concave inner surface 122.

The various embodiments disclosed herein may also be configured to workwith robotic surgical systems and what is commonly referred to as“Telesurgery.” Specifically, these features could be included on the‘end effectors’ designed to interact laparoscopically with the tissue atthe surgical site. Such robotic systems employ various robotic elementsto assist the surgeon and allow remote operation (or partial remoteoperation) of surgical instrumentation. Various robotic arms, gears,cams, pulleys, electric and mechanical motors, etc. may be employed forthis purpose and may be designed with a robotic surgical system toassist the surgeon during the course of an operation or treatment. Suchrobotic systems may include remotely steerable systems, automaticallyflexible surgical systems, remotely flexible surgical systems, remotelyarticulating surgical systems, wireless surgical systems, modular orselectively configurable remotely operated surgical systems, etc.

The robotic surgical systems may be employed with one or more consolesthat are next to the operating theater or located in a remote location.In this instance, one team of surgeons or nurses may prep the patientfor surgery and configure the robotic surgical system with one or moreof the instruments disclosed herein while another surgeon (or group ofsurgeons) remotely controls the instruments via the robotic surgicalsystem. As can be appreciated, a highly skilled surgeon may performmultiple operations in multiple locations without leaving his/her remoteconsole which can be both economically advantageous and a benefit to thepatient or a series of patients.

The robotic arms of the surgical system are typically coupled to a pairof master handles by a controller. The handles can be moved by thesurgeon to produce a corresponding movement of the working ends of anytype of surgical instrument (e.g., end effectors, graspers, knifes,scissors, etc.) which may complement the use of one or more of theembodiments described herein. The movement of the master handles may bescaled so that the working ends have a corresponding movement that isdifferent, smaller or larger, than the movement performed by theoperating hands of the surgeon. The scale factor or gearing ratio may beadjustable so that the operator can control the resolution of theworking ends of the surgical instrument(s).

The master handles may include various sensors to provide feedback tothe surgeon relating to various tissue parameters or conditions, e.g.,tissue resistance due to manipulation, cutting or otherwise treating,pressure by the instrument onto the tissue, tissue temperature, tissueimpedance, etc. As can be appreciated, such sensors provide the surgeonwith enhanced tactile feedback simulating actual operating conditions.The master handles may also include a variety of different actuators fordelicate tissue manipulation or treatment further enhancing thesurgeon's ability to mimic actual operating conditions. As noted above,the RF concentration feature allows for the power level used for “CUT”mode to be reduced. By reducing the power level, the RF concentrationfeature may be beneficial to the added precision provided by a roboticsystem.

From the foregoing and with reference to the various figure drawings,those skilled in the art will appreciate that certain modifications canalso be made to the present disclosure without departing from the scopeof the same. While several embodiments of the disclosure have been shownin the drawings, it is not intended that the disclosure be limitedthereto, as it is intended that the disclosure be as broad in scope asthe art will allow and that the specification be read likewise.Therefore, the above description should not be construed as limiting,but merely as exemplifications of particular embodiments. Those skilledin the art will envision other modifications within the scope and spiritof the claims appended hereto.

What is claimed is:
 1. An electrosurgical electrode, for coagulating andcutting tissue, comprising: a main body fabricated from a conductivematerial, the main body including a distal end portion and a proximalend portion, the distal end portion including: a linear long legdefining a longitudinal axis, a linear short leg extending perpendicularto the longitudinal axis, and a curved segment interconnecting the longand short legs; and a planar inner surface configured for tuggingtissue, and a planar outer surface, opposite the inner surface,configured to receive a first electrosurgical waveform for coagulatingtissue; and a blade fixed to the inner surface along at least the linearlong leg and the curved segment and configured to receive a secondelectrosurgical waveform different than the first electrosurgicalwaveform, wherein: the blade has an edge configured to concentrate RFenergy from the second electrosurgical waveform for cutting tissue beingtugged by the inner surface of the distal end portion; the blade extendsinwardly from the inner surface in a direction away from the outersurface; and the blade extends between a proximal end extending from theinner surface along the linear long leg and a distal end disposedproximal to the linear short leg and extending from the inner surfacealong the curved segment.
 2. The electrosurgical electrode according toclaim 1, wherein the blade has a pair of opposite side surfacesconverging toward the edge.
 3. The electrosurgical electrode accordingto claim 2, wherein the pair of opposite side surfaces are coated with anon-conductive material.
 4. The electrosurgical electrode according toclaim 3, wherein the edge is devoid of the non-conductive material. 5.The electrosurgical electrode according to claim 4, wherein the innerand outer surfaces of the distal end portion are coated with thenon-conductive material.
 6. The electrosurgical electrode according toclaim 5, wherein the coating of the non-conductive material on the pairof opposite side surfaces is thicker than the coating of thenon-conductive material on at least one of the inner or outer surfacesof the distal end portion.
 7. The electrosurgical electrode according toclaim 1, wherein the blade and the main body are coextruded.
 8. Anelectrosurgical electrode, for coagulating and cutting tissue,comprising: a main body fabricated from a conductive material andincluding: a proximal linear segment, a distal linear segment, and anarcuate segment interconnecting the proximal and distal linear segments;and a planar inner surface configured for tugging tissue and a planarouter surface, opposite the inner surface, configured to receive a firstelectrosurgical waveform for coagulating tissue; and a conductive bladefixed to the inner surface along at least the proximal linear segmentand configured to receive a second electrosurgical waveform differentthan the first electrosurgical waveform, wherein: the conductive bladehas a sharp edge configured to concentrate RF energy from the secondelectrosurgical waveform for cutting tissue being tugged by the innersurface of the main body; the conductive blade projects from the innersurface of the main body in a direction away from the outer surface; andthe blade extending between a proximal end extending from the innersurface along the proximal linear segment and a distal end disposedproximal to the distal linear segment.
 9. The electrosurgical electrodeaccording to claim 8, wherein the conductive blade has a pair ofopposite side surfaces converging toward the edge.
 10. Theelectrosurgical electrode according to claim 9, wherein the pair ofopposite side surfaces are coated with a non-conductive material. 11.The electrosurgical electrode according to claim 10, wherein the edge isdevoid of the non-conductive material.
 12. The electrosurgical electrodeaccording to claim 11, wherein the inner and outer surfaces of the mainbody are coated with the non-conductive material.
 13. Theelectrosurgical electrode according to claim 12, wherein the coating ofthe non-conductive material on the pair of opposite side surfaces isthicker than the coating of the non-conductive material on at least oneof the inner or outer surfaces of the main body.
 14. An electrosurgicalelectrode, for coagulating and cutting tissue, comprising: a main bodyincluding a distal end portion and a proximal end portion, the distalend portion including: a linear long leg defining a longitudinal axis, alinear short leg extending perpendicular to the longitudinal axis, and acurved segment interconnecting the long and short legs; an inner surfaceconfigured for tugging tissue; and an outer surface, opposite the innersurface; and a blade fixed to the inner surface along at least thelinear long leg and the curved segment, wherein: the blade has an edgeconfigured to concentrate RF energy for cutting tissue being tugged bythe inner surface; the blade extends inwardly from the inner surface ina direction away from the outer surface; and the blade extends between aproximal end extending from the inner surface along the linear long legand a distal end disposed proximal to the linear short leg and extendingfrom the inner surface along the curved segment.